{template "mheader.html"}

<div class="portlet light ">

    <div class="portlet-body form fc-form">
        <form action="" class="form-horizontal" method="post" name="myform" id="myform">
            {$form}
            <div class="form-group">
                <label class="col-md-2 control-label">账号</label>
                <div class="col-md-9">
                    <p class="form-control-static"> {$member.username} </p>
                </div>
            </div>
            <div class="form-group">
                <label class="col-md-2 control-label">可用余额</label>
                <div class="col-md-9">
                    <p class="form-control-static"> ￥{number_format($member.money, 2)}元 </p>
                </div>
            </div>
            <div class="form-group">
                <label class="col-md-2 control-label">冻结资金</label>
                <div class="col-md-9">
                    <p class="form-control-static"> ￥{number_format($member.freeze, 2)}元 </p>
                </div>
            </div>
            <div class="form-group">
                <label class="col-md-2 control-label">提现金额</label>
                <div class="col-md-9">
                    <label><input type="text" name="data[value]" class="form-control" placeholder=""></label>
                </div>
            </div>
            <div class="form-group">
                <label class="col-md-2 control-label">收款账号信息</label>
                <div class="col-md-9">
                    <textarea class="form-control" name="data[content]" placeholder="银行账号请填写: 开户行 账号 姓名" rows="3"></textarea>
                </div>
            </div>
            <div class="form-group">
                <label class="col-md-2 control-label">申请手续费</label>
                <div class="col-md-9">
                    <p class="form-control-static"> {if $ci->member_cache['pay']['cash']['price']} {$ci->member_cache['pay']['cash']['price']}% {else}免费{/if} </p>
                </div>
            </div>



            <div class="form-group margin-top-40">
                    <button type="button" onclick="dr_ajax_submit('{dr_now_url()}', 'myform', '2000', '{$reply_url}')" class="btn red btn-block"> 提交申请 </button>

            </div>
        </form>
    </div>
</div>

<script type="text/javascript">
    // 顶部"..."弹出菜单
    var menus = ['提现管理', '提现申请'];
    var menu_url = ["{dr_member_url('cash/index')}", "{dr_member_url('cash/add')}"];
</script>

{template "mfooter.html"}